Meta-Analysis of Number Needed to Treat for Diagnosis of Melanoma by Clinical Setting.

Publication date: Jan 10, 2020

The number needed to treat or excise (NNT) is commonly used to measure the number of skin biopsies performed to detect one melanoma. The NNT for melanoma varies widely between clinical settings.

To provide a formal statistical comparison of the efficacy of melanoma detection between different clinical settings.

A systematic review and meta-analysis of all relevant observational studies on NNT in relation to melanoma was performed on MEDLINE. We performed a random effects model meta-analysis and reported NNTs with 95% confidence intervals (CIs). The subgroup analysis was related to clinical setting.

In all, 29 papers including a total of 398,549 biopsies/excisions were analyzed. The overall NNT was 9.71 (95% CI, 7.72-12.29): 22.62 (95% CI, 12.95-40.10) for primary care, 9.60 (95% CI, 6.97-13.41) for dermatologist, and 5.85 (95% CI, 4.24-8.27) for pigmented lesion specialists.

There is heterogeneity in data reporting and possibility of missing studies. In addition, the incidence of melanoma varies among clinical settings and could affect NNT calculations.

Specialists have the lowest NNT, followed by dermatologists, suggesting involving specialists in the diagnosis and treatment of pigmented skin lesions can likely improve patient outcomes.

Petty, A.J., Ackerson, B., Garza, R., Peterson, M., Liu, B., Green, C., and Pavlis, M. Meta-Analysis of Number Needed to Treat for Diagnosis of Melanoma by Clinical Setting. 25438. 2020 J Am Acad Dermatol.

Concepts Keywords
Biopsies Melanoma NNT melanoma
Confidence Intervals Surgery
Dermatologist Melanoma
Excise Medicine
Heterogeneity Medical specialties
Incidence RTT
Lesion Clinical medicine
MEDLINE Cancer
Melanoma Skin biopsy
Meta Analysis NNT
Primary Care
Subgroup

Semantics

Type Source Name
disease MESH Diagnosis
disease MESH Melanoma
pathway KEGG Melanoma

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